Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2025; 16(6): 103875
Published online Jun 18, 2025. doi: 10.5312/wjo.v16.i6.103875
Clinical comparison of arthroscopic double-row rotator cuff repair with or without long head of biceps tendon transposition
Yu-Jun Zhou, Bei-Bei Wang, Hua-Wei Wen, Liang Xu, Jing Feng, Fu-Sheng Xu
Yu-Jun Zhou, Department of Trauma Center, Wuhan No. 1 Hospital, Wuhan 430022, Hubei Province, China
Bei-Bei Wang, Department of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
Hua-Wei Wen, Department of Sports Medicine, Wuhan Fourth Hospital, Wuhan 430033, Hubei Province, China
Liang Xu, Department of Orthopedic, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Jing Feng, Fu-Sheng Xu, Department of Orthopedics, Wuhan No. 1 Hospital, Wuhan 430022, Hubei Province, China
Co-first authors: Yu-Jun Zhou and Bei-Bei Wang.
Co-corresponding authors: Jing Feng and Fu-Sheng Xu.
Author contributions: Zhou YJ and Wang BB contributed equally to this article, they are the co-first authors of this manuscript; Zhou YJ, Wang BB, Wen HW, Xu L, Feng J, and Xu FS reviewed and edited the manuscript; Wang BB conducted the data collation; Zhou YJ, Wen HW, Xu L, Feng J, and Xu FS wrote the manuscript; Zhou YJ, Wang BB, Feng J, and Xu FS carried out methodology; Feng J and Xu FS supervised, contributed equally to this article, they are the co-corresponding authors of this manuscript; Zhou YJ, Wang BB, Feng J, and Xu FS conceived; and all authors have read and approved the final manuscript.
Supported by the General Program of the Hubei Provincial Natural Science Foundation of China Key Project, No. 2021CFB520.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Wuhan Fourth Hospital, approval No. KY2023-035-01.
Informed consent statement: We applied for and received approval for an informed consent waiver from Wuhan No. 1 Hospital, approval No. AF/KYSQ-09/04.0.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Sheng Xu, MD, Associate Chief Physician, Department of Orthopedics, Wuhan No. 1 Hospital, No. 215 Zhongshan Avenue, Qiaokou District, Wuhan 430022, Hubei Province, China. xfsjs2000@163.com
Received: December 4, 2024
Revised: April 24, 2025
Accepted: May 27, 2025
Published online: June 18, 2025
Processing time: 197 Days and 2.3 Hours
Abstract
BACKGROUND

Long head of biceps tendon (LHBT) transposition is a novel technique based on the double-row suture bridge method, utilizing autologous reconstruction to treat massive rotator cuff tears.

AIM

To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.

METHODS

This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021. The patients were divided into the double-row repair group (conventional group) and the double-row repair combined with the LHBT transposition group (transposition group). Postoperative pain was assessed using the visual analogue scale at one week, one year, and the final follow-up. Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up. Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification, which categorizes tendon integrity based on magnetic resonance imaging findings.

RESULTS

No perioperative complications were observed in any of the patients at any time. There were no significant differences between the groups regarding operative time and intraoperative blood loss. The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively; however, there were no significant differences between the groups at one year or the final follow-up. At one year postoperatively, the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group; no significant differences were observed at the final follow-up. There were no significant differences in rotator cuff healing between the groups at one year postoperatively.

CONCLUSION

Compared to double-row repair alone, double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.

Keywords: Rotator cuff repair; Double-row technique; Biceps tendon; Transposition; Outcomes

Core Tip: Our study shows that combining double-row repair with biceps tendon transposition for massive rotator cuff tears reduces early pain, speeds recovery, and improves function by 15% at one year - without added complications. At three years, 88% of patients maintained good tendon healing. This method offers a simpler and more economical alternative to traditional graft-based reconstructions for massive rotator cuff tears.